Fiegel H C, Kneser U, Kluth D, Rolle U
Goethe Universität Frankfurt, Kinderchirurgie, Theodor-Stern-Kai 7, Frankfurt.
Handchir Mikrochir Plast Chir. 2010 Dec;42(6):337-41. doi: 10.1055/s-0030-1252045. Epub 2010 Apr 19.
Today liver transplantation is the only curative option for the treatment of end-stage liver diseases. A major limitation of liver transplantation is the donor organ shortage. Therefore, tissue engineering based cell transplantation is currently under investigation with the aim to replace liver tissue and function. The principle of tissue engineering is the notion of an interaction between a cell and a three-dimensional matrix. The matrix serves as a scaffold and guides a three-dimensional cell assembly. In addition, the matrix provides for a regulation of cell proliferation and function by cell-matrix interactions. In cultures of hepatocytes a regulation of cell proliferation and specific function by using three-dimensional matrices and by modifying the surface with isolated molecules of the extracellular matrix has been demonstrated. Furthermore, a beneficial effect of a flow bioreactor system on cell viability and function was observed. In addition, a system for heterotopic hepatocyte transplantation on polymeric matrices was developed in an animal model. In this transplantation model a long-term proliferation and function of transplanted hepatocytes was shown. The major limitation of matrix-based transplantation systems is the high initial cell loss, most probably due to an insufficient vascularisation. Thus, the development of vascularised matrices and the creation of bile ducts remain major problems in the technologies of hepatic tissue engineering and have to be addressed to enable further advances towards clinical applications.
如今，肝移植是治疗终末期肝病的唯一治愈性选择。肝移植的一个主要限制是供体器官短缺。因此，基于组织工程的细胞移植目前正在研究中，旨在替代肝组织和功能。组织工程的原理是细胞与三维基质之间相互作用的概念。基质作为支架，引导三维细胞组装。此外，基质通过细胞-基质相互作用调节细胞增殖和功能。在肝细胞培养中，已证明使用三维基质并通过用细胞外基质的分离分子修饰表面来调节细胞增殖和特定功能。此外，观察到流动生物反应器系统对细胞活力和功能有有益影响。此外，在动物模型中开发了一种在聚合物基质上进行异位肝细胞移植的系统。在这个移植模型中，显示了移植肝细胞的长期增殖和功能。基于基质的移植系统的主要限制是初始细胞损失高，这很可能是由于血管化不足。因此，血管化基质的开发和胆管的创建仍然是肝组织工程技术中的主要问题，必须加以解决，以便在临床应用方面取得进一步进展。
